Friday, July 24, 2009

Sneak peek: Prologue

Hello all,

I appreciate very much the community that has developed around this blog (and others) over the last few years. Which is why I'm asking if you will do me a favor and read the prologue of the book I'm working on, tentatively called THE DEMON IN THE BAKERY. It's a family memoir about my daughter Kitty's anorexia and recovery.

Warning: This prologue may be triggering for those who are actively eating-disordered or in recovery, so please, skip it.

The rest of you--I'd value your honest reactions and feedback.

Thanks.

PROLOGUE: THE DEMON IN THE BAKERY

Close your eyes. Imagine that you’re standing in a bakery. Not just any bakery—the best bakery in Paris, its windows fogged, crowded with people who jostle for space in front of its long glass cases. The room is fragrant and you can’t take your eyes off the rows of cinnamon rolls and croissants, iced petits fours, flaky napoleons and elephant ears. Every counter holds at least one basket of crusty baguettes, still warm from the oven. And you’re hungry. In fact, you’re starving. Hunger is a tornado whirling in your chest, a bottomless vortex at your core. Hunger is a tiger sharpening its claws on your tender insides. You stand in front of the glass cases, trying to swallow, but your throat is dry and your stomach clenches and contracts. You want more than anything to lick the side of an éclair, swirl the custard and chocolate against your tongue. You dream about biting off the end of a cruller, feeling the give of the spongy dough, the brief molecular friction of the glaze against your teeth, flooding your mouth with sweetness. The woman beside you reaches into a white paper bag, pulls out a hunk of sourdough roll. You see the little puff of steam that flares from its soft center. She pops it into her mouth and chews and you chew along with her. You can almost taste the bread she’s eating. Almost. But you can’t, not really, because how long has it been since you’ve tasted bread? A month? A year? An eternity. And though your stomach grinds against your backbone and your cheeks are hollow, though the tiger flays your belly, you can’t eat. You want to, you have to, but your fear is greater than your hunger. Because when you do—when you choke down a spoonful of plain yogurt, five pretzel sticks, a grape—that’s when the voice in your head starts up, a whisper, a cajoling sigh: You don’t need to eat, you’re strong, so strong. That’s right. Good girl. Soon the whisper is a hiss filling the center of your head: You don’t deserve to eat. You’re weak, unworthy. You are disgusting. You don’t deserve to live. You, you, you. The voice is a drumbeat, a howl, a knife sunk in your gut, twisting. It knows what you’re thinking. It knows everything you do. It has always been inside you and it always will be. The more you try to block it out, the louder it becomes, until it’s screaming in your ear: You’re fat. You’re a fat pig. You make everyone sick. No one loves you and no one ever will. You don’t deserve to be loved. You’ve sinned and now you must be punished. So you don’t eat, though food is all you think about. Though all day long, wherever you are—doing homework, sitting with friends, trying to sleep—part of you is standing in the bakery, mesmerized with hunger and with fear, the voice growling and rumbling. You have to stand there, your insides in shreds, empty of everything but your own longing. There will be no bread for you, no warm, buttery pastries. There’s only the pitiless voice inside your head, high-pitched, insistent, insidious. There’s only you, more alone than you’ve ever been. You, growing smaller and frailer. You, with nowhere else to go. The voice is part of you now, your friend and your tormentor. You can’t fight it and you don’t want to. You’re not so strong, after all. You can’t take it and you can’t get away. You don’t deserve to live. You want to die. This is what it feels like to have anorexia.

* * *

I’ve never had anorexia, but I’ve lived with it. I’ve observed it closely in someone I love: my oldest daughter, Kitty, who was 14 when she got sick. I watched as the happy, affectionate girl I knew became furious and irrational, obsessed with food but unable to eat. I saw her writhe in terror, heard her beg my husband and me for help and then, in the same breath, shriek that we were trying to poison her, to make her fat, to kill her. I heard a voice I did not recognize come out of her mouth, saw her gaunt face changed beyond knowing. I held her in my arms and felt the arc of every rib, counted the bones in her elbows, saw her breastbone press out through the paper-thin skin of her chest. I felt her body shake and knew that whatever comfort I offered it wasn’t enough, it was nothing in the face of the thing that was stripping the flesh from her bones and the light from her eyes. I had no idea anorexia was like that. Before Kitty got sick, I thought eating disorders happened to other people’s children. Not to my daughter, who was savvy and wise, strong and funny, the kind of kid who picked her way through the pitfalls of toxic middle-school friendships. She did fit the profile: she was a perfectionist, fastidious about how she looked and dressed. She was hard on people sometimes, especially herself. She was athletic, a gymnast, traveling around the Midwest for meets; her favorite event was the balance beam—fitting, I thought, for a child who so gracefully walked the line between childhood and adolescence. But she would never have an eating disorder. She was way too smart for that. Before my daughter got sick, I thought kids with anorexia or bulimia wanted attention, that they were screwed up and tuned out, bored or acting up or self-destructive. But my daughter was none of those things. She seemed cheerful and well adjusted; she had friends, interests, a passion for new experiences. She wrote her sixth-grade research paper on eating disorders. She knew the dangers. She would never choose to have anorexia. She was safe. I was wrong about many things, but I was right about that one thing: Kitty didn’t choose anorexia. Anorexia chose her. And it nearly killed her. At Kitty’s lowest weight, her heart beat dangerously slowly; it could have stopped at any time. Between 10 and 20 percent of people with anorexia die from heart attacks, other complications, and suicide; the disease has the highest mortality rate of any mental illness. Or Kitty could have lost her life in a different way, lost it to the rollercoaster of relapse and recovery, inpatient and outpatient that eats up, on average, five to seven years. Or a lifetime: only half of all anorexics recover in the end. The other half endure lives of dysfunction and despair. Friends and families give up on them. Doctors dread treating them. They’re left to stand in the bakery with the voice ringing in their ears, alone in every way that matters. Kitty didn’t choose anorexia because no one chooses anorexia, or bulimia, or any other eating disorder. Intelligence is no protection; many of the young women (and, increasingly, men) who develop anorexia are bright and curious and tuned in. Families are no protection, either, because anorexia strikes children from happy families and difficult ones, repressed families and families who talk ad nauseam about feelings. The families of anorexics do share certain traits, though: A history of eating disorders, or anxiety, or obsessive-compulsive disorder. Or all of the above. I’ve never had anorexia, but I know it well. I see it on the street, in the gaunt and sunken face, the bony chest, the spindly upper arms of an emaciated woman. I’ve come to recognize the flat look of despair, the hopelessness that follows, inevitably, from years of starvation. I think: That could have been my daughter. It wasn’t. It’s not. If I have anything to say about it, it won’t be. This is the story of our family’s struggle. Kitty was diagnosed with anorexia in June 2005. In August of that year we began family-based treatment (FBT), also known as the Maudsley approach, to help her recover. That was the start of the hardest year of our lives and, especially, Kitty’s. That year, I learned just how brave my daughter is. Five or six times a day, she sat at the table and faced down panic and guilt, terror and delusions and physical pain, and kept going. And she emerged on the other side. After months of being lost, she came back to us and to herself, and the world took on color and sound and meaning once more. So this book is for Kitty, and for all the children and teenagers and adults who have struggled or continue to struggle with an eating disorder: for your courage, your strength, your capacity to not just endure but overcome. I honor you with every word.

This will be a difficult read for anyone who has personally been affected by anorexia. I've had the horror of watching students starve & die, family members suffer, and walked along that awful edge for many years myself. Difficult or not, it is an important story and one that I hope will connect with all the other families, teachers and caregivers who deal with this tragic and misunderstood form of ED.

I am generally not a fan of the memoir genre, but I would buy and read this book.

As a reader and a writer, though, I will caution you against statistics and sermoninzing as you write. In this particular exerpt, the use of statistics pulled the reader OUT of the emotionally engaging and very personalized narrative that preceded it. But perhaps thats what you intended--the 2nd person narrative is emotionally intense, the strongest part. The academic part grounds the reader as well as pulls one out of the narrative.

that was really amazing but I couldn't get through the whole thing as someone who is on the way back from recovery. it was a little too close for me right now. its obvious that his is going to be a great book.

I want to read this book, even though I know I'll have to have a full box of Kleenex by my side the whole time.

Unlike Rachel, though, I find the statistics useful and grounding, even in the midst of the clearly emotional writing.

I do however, agree with Sharon C about 'molecular friction.' I think a good editor will want you to tone down some of the phrases as a touch overdramatic, too.

OTOH, the bones of the narrative are strong. The story you have to tell is important. The emotional content is powerfully moving. I don't think you'll have much trouble shopping this one. You might even wind up with a tiny bidding war on your hands. Make sure you've got good advice and a strong negotiator on your side.

Seriously, this is a book I would absolutely read. I think I'm far from the only one who would want to learn from your experiences and Kitty's courage.

I would object to the blanket statement "this is what it feels like to have anorexia." That was never what it felt like for me to have anorexia. And it most likely will not be what it felt like for several other people who have or had anorexia. It may be what it feels like for some people to have anorexia or what you imagine it feels like for people to have anorexia but it is not some kind of defining be all and end all of what it means and feels like to have anorexia. My two cents for whatever it's worth.

Thank you to everyone who has commented so far. I take all your comments to heart. Just FYI, the book has already been sold and will be published in fall 2010 by HarperCollins.

Jessie, I have thought long and hard about the point you raise. I know that people have different experiences of anorexia as they do of, well, just about everything. I've wrestled with how to make the point in a powerful way without making, as you say, a blanket statement, and I've come to the conclusion that I can't. Later in the book I will absolutely talk about the fact that people experience anorexia in many ways. And even the same people experience it differently at different times in their lives. Your comment will inspire me to keep thinking about it, so thank you.

As for molecular friction, alas, that is of course my favorite phrase. :) And that's often the one that has to go.

Harriet, your writing is beautiful and powerful. My only pair of reservations, and they were pretty much instantaneous, were (1) if I didn't need to, I wouldn't read the whole book because it is so terrifying, and (2) in alcohol addiction, people get confused by hearing about "worst cases" because they think "I'm not that bad, so I don't have it" -- if you are describing something on the far end of the spectrum, you may be preventing some people from recognizing themselves. But ... those are very personal reactions of mine. A big Vermont hug goes with them.

That's helpful, Beth, because this was not a "worst case" by any means. In fact, by the usual standards, my daughter was sick only briefly. She never had to go away to residential care, didn't have relapse after relapse, etc. I will make sure to make that clear.

Hi. I've just recently started following your blog. I'm very impressed by this piece. Wow. For someone who's never had an eating disorder, you get it down! Especially powerful is your description of that incessant voice. I'm in treatment, and *it never shuts up*. You really drive that home.

My only comment would be about the second time you write, "I've never had anorexia, but I know it well." You then go on to write about an emaciated woman on the street. So many people with eating disorders - including anorexia - are not emaciated. Most people with eating disorders - even most of the people who die of them - are within a "healthy" weight range. This one passage struck me as reinforcing the idea that one must be emaciated to have an eating disorder, and that idea, unfortunately, keeps a lot of people out of treatment.

Hey, Harriet. I'm really grooving with you on this. I have a couple of little suggestions: that first paragraph is *begging* for more smell words, and I felt jarred from "Or Kitty could have lost..." Even if that was a new paragraph, I think it would flow better.

Very authentic, profound, and Real! When you shared the initial analogy about a year ago I read it aloud to my parent group and the feedback was "WOW, I get it". This will be without a doubt emotional and that is the point, it is real, not meant to scare but to motivate while also empower! I am looking forward to more!

This prologue was very engaging - I want to read more! Will this book be more of a how-to for the Maudsley approach, or recollections of the struggle with anorexia from your point of view, or Kitty's perspective on things?

Katie, this will be a family memoir of dealing with anorexia, with lots of science and neurobiology woven into it. While it won't exactly be a how-to, my hope is that families who want to use FBT will find this a helpful guidebook of sorts. And an inspiration.

formyed, it's true that many people with ed are not emaciated. thanks for pointing that out.

Beautifully worded. I would definitely read it. I wish i could say more, but i have no way with words.

I also agree with the 'emaciated' image comment though. At my lowest weight, and sickest, i would probably still be too 'fat' for anorexia. I feel many ED sufferers are almost aiming to look that sick, just so people believed them. I know i did. I read the weights or see images on TV of 'the anoretic' and feel that even in sickness, i failed.

You've gotten a lot of great feedback already, so I'll just say that I found this very moving and look forward to reading the book.

I can't remember whether you posted this spring about Laurie Halse Anderson's new YA book "Wintergirls." It's a novel about an anorexic girl, and while most reviewers agree that it's beautifully written and very moving, there's been some controversy over whether it's a good idea to publish a book that might be so triggering to some people. I'd be interested in your take on it.

I definitely think you "get it." I have been there and the read was difficult but, as a woman who is recovered (and recovery is possible) it really moved me and made me think about what these young girls and boys, women and men, experience and how hard it is to face the demons head on and come out on the other side. Maybe one day you and Kitty can write a book together to get the story from a different and unnique perspective!! Write on, friend, write on!!

As a sibling of a recovering/recovered anorexic, I'm curious how your other daughter will manifest in the narrative. The more I read about at-home treatment options for eating disorders, the more I think about the role of siblings.

hi anon,she is certainly in the narrative, and i can tell you that this whole process has been very very painful for her. i'm sure it has been for you too. my sister was actually ill with something different but analogous when i was young and i carried the pain and anger of that with me for many years. i wish you well.

I wish my mother had been half as supportive as you are to your child.

She always ridiculed me about my body and i really were not as she made me feel.

and when i studied and it was all so stressfull and was mobbed again from collegues(i always was the punchin bag) i lost my appetite.

I could not really eat, i thought about food because i was hungry but felt always like retching, tried to eat in a way i would not loose too much nutrition and when i could see the bones of my ribcage in the mirror the only thing my mother said when she saw me....

"Oh how nice you look now that you are a bit thinner"

It was crushing...she never saw me, she just saw herself in a younger body.

I can not really wrap my mind around the thing that people in a healthy family and environment may get such an illness(because..well..how can someone who is loved hurt themself in such a way? )..but that seems to be the way it is...

there are so many things that can trigger this you can not imagine, and every person is different

and maybe a single thoughtless comment can get you there after it slumbered in you for years..just like cancer. one smokes and stays healthy and the other never smokes and gets cancer

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About Me

I teach magazine journalism at the S.I. Newhouse School of Public Communications, and write for many magazines and newspapers. My newest book is BRAVE GIRL EATING: A FAMILY'S STRUGGLE WITH ANOREXIA, which will be published by William Morrow this fall. I believe in the power of words to change the world (or at least the interior lives of individuals).